The fight over healthcare is leading some to consider something radical

The UK technically has four different national healthcare systems, one for each country that makes up the union, but the general construct is known as the National Health System.
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Since Republicans took over Congress, Obamacare has become more popular. Surveys from the Kaiser Family Foundation show the number of Americans supporting it went from 38% a year ago to 49% today.

But Obamacare, itself a compromise, has real problems, and its limitations — and the growing backlash to Republican efforts to repeal it — have given an opening to an idea that until now has had little traction in the US.

The idea is single-payer healthcare, and if the US adopted it, it'd be a radical change. At its core, the idea is that the government, in some form, would pay for all or most healthcare expenses.

In business circles, states, and even the top levels of some insurers bringing some form of a single-payer healthcare system is beginning to gain traction.

Business leaders including famed investor Warren Buffett and Charlie Munger said that single-payer healthcare is the solution to the increasingly high levels of healthcare expenditures in the US. Even Aetna CEO Mark Bertolini, the top executive at one of the five major publicly traded US insurers, said at a staff meeting in May that a modified form of single-payer is a "conversation" the US should begin to start.

On Capitol Hill, while the American Health Care Act would take the US further away from single-payer, Sen. Bernie Sanders has again introduced his Medicare-for-all bill that would create a single-payer system.

During his campaign, Sanders showed that the appetite among the American left is growing for the policy. So what exactly is single-payer?

While it may seem simple enough, there are actually a number of different forms a government-funded healthcare system could take.

We've broken down the single-payer healthcare systems in Canada, the UK, and Taiwan, along with one non-single-payer but intriguing option in Germany, to see where the US system could go next. While these breakdowns aren't comprehensive, they highlight the types of single-payer systems that the world uses.

The basics

There are a few ways that single-payer can work, but at its core it is the government paying for healthcare services through revenue generated via taxation.

Put another way, people who live in a country pay into a pot of money through their taxes. The government then takes this pot of money and pays drugmakers, healthcare facilities, and doctors.

One of the hallmarks of a single-payer system is the ability for the government to have more control over prices.

For instance, in many single-payer systems, the government can negotiate prices for prescriptions drugs since it controls the purse for much of the spending. This makes sense because in the case of the UK, nearly 80% of the healthcare spending comes from the government. So if a drug is not bought by the government, it almost totally closes off the market to a pharmaceutical company. This gives the government a lot of bargaining power.

Payments to healthcare providers, prescription drugs, and other aspects of the system are all subject to price negotiation with the government in single-payer systems.

Across different countries, however, it can take different forms.

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Canada: government single-payer, but private healthcare providers

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Canada's single-payer system is mostly run by provincial and territorial governments, but is funded heavily by the federal government. The federal government also sets baselines of standards for care at the provincial level.

Each province sets its own ambulance fees, reimbursement rates for doctors, and other system fees. Most of the costs are covered by the government or supplemental private insurance, but out-of-pocket spending accounted for 14% of all healthcare spending in 2014 (a bit higher than the 11% in the US).

The federal government does set some national cost standards, however, including for pharmaceuticals. The Patented Medicine Prices Review Board is federally run and helps to negotiate and set the prices for drugs under patent. While the Pan-Canadian Pharmaceutical Alliance handles some drugs not on patent, provincial governments handle the bulk of the negotiations over the prices.

Many Canadians opt to get additional private insurance because it covers things that aren't publicly reimbursed like dental and eye care and has some nicer benefits like private rooms in hospitals and rehab care. So while public insurance is a base layer, the optional private insurance goes a step beyond.

While two-thirds of Canadians have private insurance, the bulk (94%) of the costs are paid by employers, unions, and groups. Private insurance costs made up roughly 12% of total healthcare spending in 2014, compared to 33% of healthcare spending in the US. (The rest is Medicare and Medicaid.)

In terms of facilities, most primary-care doctors are private individuals or groups who receive reimbursement from the government. Hospitals are a mix of public and private, with a bulk being nonprofit, with some provinces having a heavier weighting toward private facilities.

About 66% of primary-care doctors are private contractors. The doctors, called general practitioners (GPs), receive payment at a rate set between their lobbying group the British Medical Association and the NHS. In contrast to the US, many doctors assign a patient a specific time to arrive at the doctor, rather than providing options the patient can choose from.

A large majority of patients get their services from NHS-funded hospitals, but there are private-care facilities that can offer more specialized care or shorter wait times.According to the government, in 2012-2013, 8.77 million people received surgery at a NHS hospital compared to 1.61 million in private facilities.

There is some private insurance that can be added on top of the basic NHS policy, but in 2015 only 10.5% of those in the UK elected to add on the coverage. Most of these policies do not cover the basics from the NHS, but provide additional coverage for specialized care or going to a private healthcare provider.

Taiwan: a premium-based system

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In the 1990s, Taiwan had undergone a massive economic boom and a shift from martial law. With the newfound wealth and government reforms, the country decided to reform its healthcare system, setting up a commission that studied systems across the world to find and adopt the best practice it found.

Taiwan's healthcare system is run through the National Health Insurance Administration and features a premium-based system different from Canada and the UK.

Instead of money taken out of annual taxes, Taiwanese make monthly premium payments based on their payroll income and nonpayroll income. There are also taxes on tobacco and lottery winnings that add money to the system. Premium payments are split between employers, the government, and individuals with adjusted rates based on income levels.

Put another way, instead of taking a chunk of money from overall taxes into the system, the Taiwanese pay a monthly fee from their paychecks that goes directly into the pot.

There is some co-payment and co-insurance that fall on citizens, but these levels are capped based on criteria like the type of sickness or the length of stay in a hospital.

The public system, in comparison to Canada or the UK, is almost totally comprehensive even covering Chinese medicine and specialty care.

The widespread use of advanced technology and lower overhead costs are aided by a small geographic area and somewhat smaller population.

Very few Taiwanese have additional private insurance. Those plans tend to cover specific diseases.

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Germany: a non-single-payer idea

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If the US swings left and decides to move toward true universal healthcare, it may end up looking more like Germany's compulsory health-insurance system rather than a traditional single-payer like the UK.

There are two types of coverage in Germany: statutory health insurance (SHI), aka sickness funds, and private health insurance (PHI).

As a way to think of it, the SHIs are more like the single-payer government-funded plans like the UK and Canada, while the PHIs operate like the US system. Since there are two groups, this means the country does not qualify as single payer.

SHIs are made up of nonprofit firms that compete to sign up Germans, funded through a premium-based payroll tax split between the worker and their employer and taxes in the German Health Care Fund. SHI insurers are then reimbursed by the government on a risk-adjusted basis (meaning those that have sicker customers get more, while those with a healthier pool get less). There are some co-payments for care under an SHI, but these are fairly low. For instance, co-pays for prescriptions range from five to 10 euros.

People on SHIs make up most of the population (86% of the population), with anyone making under 56,250 euros automatically enrolled in these plans. People making above the threshold can also remain in the SHI and roughly three-fourths choose to do so.

Doctors that receive SHI reimbursements are by law required to join regional associations which set the reimbursement prices.